shine on

Found it interesting info. Link was to pics indicating some hope for those with poor strip donor results.

(promotional link removed) Dr. Hitzig leads New Study of ACell's MatriStem products for scar correction and Cloning new hair growth. For more information contact: (contact info removed) Recent advances in the world of Regenerative Medicine have been very exciting. Fingertips are being regenerated, organs and heart valves have been cloned and are successfully being implanted in patients. Now one of the leading innovators in the field of regenerative medicine, ACell, Inc., has asked the Plastic Surgeons at Dr. Gary Hitzig's offices (promotional link removed ) in Rockville Centre, NY to test the use of their MatriStem product for healing the wounds associated with hair transplant sites. Dr. Hitzig and his colleagues will examine MatriStem's ability to reduce scar tissue and regenerate hair within the donor region of hair transplant patients. MatriStem will also be tested for cloning transplanted hair from the donor area and the beard and growing it in bald areas on the top of the scalp. In the past 6 months, ACell's MatriStem has been used on 8 hair transplant patients, one of which was Dr. Hitzig himself. ACell's patented Extracellular Matrix (ECM) products are covered by multiple 510(k) clearances and address important unmet clinical needs, providing safe, effective and therapeutic outcomes. Derived from porcine urinary bladders and referred to as UBM (urinary bladder matrix), trademarked as MatriStem?„?, ACell's core technology is a naturally occurring, non-crosslinked, completely resorbable acellular biomaterial. A similar "first generation" ECM technology has been used to treat over 500,000 patients with remarkable effect. ACell's MatriStem products are the next generation of ECM technology due to its unique characteristics featuring a basement membrane surface which is ideal for epithelial cell growth in many applications. "We are growing new hair in prior donor scar sites as well as duplicating (growing multiple hairs from a single transplanted beard or donor hair) in the bald recipient area" states Dr. Ted Chaglassian, a Board Certified Plastic Surgeon and former Chief of Plastic Surgery at Memorial Sloan-Kettering Hospital and Attending Physician at Columbia Presbyterian Medical Center in NYC. He further states: "Where we go from here is anyone's guess but the future of cloning growing hair has just been made a reality in the present!"

I find this encouraging information. Just speeding up recovery for the donor and recipient sites is a win in my book. Regrowth potential is icing on the cake. I keep hoping more doctors will test this protocol. Seems like there is minimal risk to HT results. I would hope numerous patients would be willing to pay for the PRP procedure if offered. I know I would.

Posted by Dr. Chris Bisanga rep on another forum: The approximate consistency of platelets in 1 cubic cm of blood is 250,000 and when concentrated with PRP can increase to 1 million, 4 times the concentration. The platelets contain the "healing" tools that are released when a wound is made. Due to the concentrated nature of PRP and the fact it can be used in specific isolated areas the platelets can react faster to the area, improving coagulation, reduce bleeding and with less fibrosis and collagen manufacture. The conclusion not just a speedier healing process but improved healing of the skin tissue reducing the signs scarring with improved healing characters. The platelets are rich in proteins and may aid the healing in the recipient placement sites for the new grafts to rest in and the donor healing of either the linear scar with Strip surgery or punch scarring with FUE surgery. The proteins growth factors should show an increase in speed of the healing, stimulating the formation of vessels so helping the follicle to bond with the site faster and with the tissue and cardio vascular system. The fibrotic inducing proteins will enhance the conversion of fibrinogen into fibrin but in a lesser amount than naturally. This conclusion can mean a scar of visibly less size, improved laxity, less separation and angle change between follicular units, reduced miniaturization and less collagen production between the fatty tissue and dermis layer. ____________________ Dr. Bisanga has finished his first phase of trials with PRP, he is pleased with many aspects of the tests, donor and recipient. He believes used in the correct circumstances PRP can aid the recovery in the recipient and donor, especially so far seen with FUE. Certainly tests in the FUE donor healing have shown significant improvements in extraction point closure and speed of recovery. This can have benefits for FUE donor harvesting and management not just for that procedure but future procedures. In the recipient we have seen improvements in healing speed and growth rates, yield no difference as we have a high yield ratio anyway, but certainly in the majority of tests so far the regrowth speed improved. There is also positive signs that miniaturised native hair in the recipient area and donor for that matter, especially surrounding the area of the HT have shown signs of improvement in the calibre and strength. Dr. Bisanga intends to continue the trials over the next 3 months, predominately with FUE patients free of charge to increase the research and potential for the treatment. (promotional link removed)

Maxxy helped answer a question I had concerning telogen hairs lost to strip surgery, linking to his similar question from early this year. http://hair-restoration-info.c...=783100201#783100201 Reading the comments, telogen hairs lost to strip appear to be hit and miss. Sounds as if a fair number of these resting hairs are lost in strip. In a multi-hair graft, telogen hairs has some slight potential to be kept for both strip and fue? While one hair telogen grafts surely get thrown out in a strip procedure. The alternative of fue leaves single graph telogen hairs undisturbed. As Maxxy notes in the linked message, the strip method limitation concerning telogen hairs conceivably equates up to a 13% loss rate. Something to consider when contemplating strip vs fue. This begets a new question about treatments to prolong the growth phase in the donor region in preparation for strip surgery, to potentially limit the number of telogen hairs lost. H&W desire patients stop minox prior to surgery. Besides minox, are there any other treatments which have the potential to keep hair out of the telogen phase, which can be used temporarily in the donor prior to a strip procedure? CP, SOD, L-arginine , et al? Any thoughts?

Thanks Maxxy The comments raise another issue. I will start a new thread.

I have seen it commented, to max the number of grafts, first max out your strip(s), then follow up with FUE. You are removing part of your scalp with strip, and moving all the corresponding grafts. Then thinning out the remaining donor through FUE. This makes sense as the ultimate graft optimization route.

jmg544 Your 4 month pic of the donor looks very good. No trace of a scar or hair ridge in the pic. What guard is your hair cut in the pic posted? Thanks!

hair_me_out I came across the HLH post right after my in office consult. Thus, I had hoped Joe would indicate the issue was addressed to the patient's satisfaction, and attempt to indicate what potentially caused the donor strip concerns. In such case, I would have scheduled a HT over the summer. Not knowing the outcome, or lessons learned, as it stood, I temporarily backed away from considering a HT. It's the "crap, that could have been me" reflex action. I agree, while I feel I am aligning myself with a top clinic, at the end of the day there are still some risks. Atomic Thanks for the insight. Yes, I have also noticed the length of H&W strip. The length is less of a concern that the width. As a NW3, if I ultimately decide on strip, it makes the most sense to attempt a one and done approach. I really commend HT veterans with 3 or more procedures. What other cosmetic procedure takes up to a year to determine the result? A boob job, and the girl is sporting her high beams only days later. While we are relegated to hiding under hats and do rags for half of a year, daily standing before the mirror trying to coax a couple HT grafts to show themselves! HT surgery is a definite case of delayed gratification. Should I need additional work down the road, my thought is FUE can discretely keep me ahead of any loss in the crown. I perused old posts on several boards, and 3MM seems to be the upper end of what is considered acceptable for top clinics on virgin scalp. As indicated, that is a number I can live with. However, I am curious how often this strip scar width is exceed. Clearly this phenomenon occurs. Hopefully, surgeons will address the figures involved.

Thanks for the reply hair_me_out. I will probably be sending you some PM as I work through my decision. As you note, this is about recreating the allusion of a full head of hair. (as we have similar loss pattern) I think this result is achievable for both of us. A scar is just the price one pays. 1-3MM width I can accept without reservation. A couple hundred FUE and/or some of the tattoo work I have seen to break up the scar would satisfactorily address. Unfortunately, even H&W have some less than desirable results. I am not singling out a clinic, all clinics have the rare poor scar result. Hasson is on my short list of one, so they are my subject matter. As I noted, I went to VYR just for a consult this spring. I was getting ready to schedule a few years back when H&W were beginning to do tri closures, and someone posted their poor scar which looked nearly 2 CM. Likewise, there was this posting last year/early this year on HLH: I didn't try to translate all of the posts. However, this type of result would be a regrettable outcome. Even when both doctor and patient perform everything by the book, patient physiology seems to occasionally lead to poor strip results. While I am 40, I have very tight scalp. Dr. Hasson even commented on my lack of laxity. Giving rise to my concerns about my 3MM line of demarcation. Beyond that width, I would regret a strip decision. I am a number cruncher by trade, so either from personal experience or as witnessed by those in the industry, what percentage of donor scars, resulting from virgin strip HT, graph count of around 3,500, typically exceed 3MM?

I've read otherwise, over the years. However, I think you take everything with a grain of salt with online BB. Maybe someone can answer what happens to telogen hairs. Maybe in a multihair grafts they might survive vs. a single hair telogen graft? When discussing the issue raised in the initial post, I think it is also imperative to question graft transactions/lost grafts while removing the strip (both those excised, and those remaining in the donor situated next to strip incisions) vs. transection rates for FUE (not just of the graft excised, but also the hairs surrounding the graft remaining in the donor). One would assume as punch size increases, this becomes more likely. Discarded or damaged grafts is something to consider when comparing strip / fue yields. As we all know, we are dealing with a very limited donor supply and we must be very judicious in our approaches.

For several years now I have been considering a HT. I get to looking at the donor from strip procedures, and it stops me dead in my tracks. It strikes me as so invasive, just to move around grafts. In response, I avoid these sites for a couple months, then out of frustration resulting from not addressing my hair loss, I come back to repeat the process. I have a long slender face, and the "shave it and forget it" look is not very becoming. I have even gone so far as an in office visit to H&W earlier this year. Recession a 3ish. However, while donor is good, donor hair has always been fairly thin. Hasson feels I need about 3,500, so clearly strip is the way to go. How did you all come to terms with accepting strip surgery scaring? Especially interested to hear from Hasson patients like Bill and hair_me_out (loss was similar to my own). Thanks!

Curious about another issue. As we are discussing graft survival, what I rarely hear discussed concerns the telogen phase hairs which get thrown out in a strip surgery. Unavoidable. However, at the end of the day, can't these lost hairs rival transaction rates? Also, I am curious about the number of grafts typically transected during the strip removal. Does a strip doctor attempt to avoid this damage while cutting out the strip? Either way, one would think at least a few are transected. I would like to get the forums take on this while the topic is on the table.

I've also been curious about how to best ensure the clinic's best techs, and their work load. Other than scheduling on a Monday, or day off, how would you know the prior day's schedule?

I wish it was a more certain outcome. However, even H&W patients have posted some less than desirable donor scars.